Provider Demographics
NPI:1861672529
Name:ADAMSON MEDICAL LLC
Entity Type:Organization
Organization Name:ADAMSON MEDICAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRIS
Authorized Official - Middle Name:RONALD
Authorized Official - Last Name:ADAMSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:765-346-1099
Mailing Address - Street 1:9138 GREEN RIDGE LN
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGTON
Mailing Address - State:IN
Mailing Address - Zip Code:47401-9077
Mailing Address - Country:US
Mailing Address - Phone:765-346-1099
Mailing Address - Fax:
Practice Address - Street 1:3209 W FULLERTON PIKE
Practice Address - Street 2:
Practice Address - City:BLOOMINGTON
Practice Address - State:IN
Practice Address - Zip Code:47403-4057
Practice Address - Country:US
Practice Address - Phone:812-825-5191
Practice Address - Fax:812-825-5197
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-11
Last Update Date:2009-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01048882207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty